The article from the Chronicle of Higher Education about Kennett, Missouri really got me thinking about disparities. Kennett, Missouri is about 35 miles south of my house. My dad was born in Kennett. My mother was from Cardwell, Missouri which is a little further south and closer to the Arkansas line. Places in rural areas like the Bootheel of Missouri tend to have more health problems than better educated and larger cities in the United States.
When you visit rural communities in Missouri, it becomes clear that health risks are created and maintained by social systems. The extent of those risks is mostly a function of socioeconomic and psychosocial disparities.
For example, some elderly residents in rural areas rely on external care: Weekly home visits from visiting nurses to distribute medication and to check vital signs. At other times, they must drive twice a week to a nearby town to change medication wraps for ulcers.
Efforts to reduce health disparities can no longer be confined to only providing better access and more resources to meet the needs of the underserved.
We must address the underlying social factors that determine health disparities.
There is too much emphasis placed on individual lifestyle choices. Everyone tends to forget that lifestyles are primarily determined by social, economic and environmental determinants except for a small-town doctor from Kennett who refuses to leave his patients.
Even when medical-school graduates benefit from debt forgiveness (after working two years in underserved and some rural areas), most of them leave the community.
This small-town doctor is a Bootheel import and served the community for 15 years. As medical director of the hospital, he treats many patients who cannot pay.
With layoffs, people losing their health insurance, and stricter Medicaid eligibility requirements in Missouri, there is a great need for doctors. And this small-town doctor can’t leave because he understands the overwhelming need for health care in the community.
Education in Rural America
In the past two decades, death rates have soared for middle-aged white Americans without an education which includes most residents of Kennett and other rural areas.
Drug use is common. The poor and least educated use drugs to numb themselves to life: Numb to job loss, bad health, and life’s disappointments.
It’s a mystery why doctors (who prescribe strong painkillers) and pharmacists (who fill the prescriptions) are not closely monitored in Missouri. A drug epidemic is another symptom of a public health crisis.
The article revealed that people with a high school diploma or less have experienced progressively early death rates since the late 1990s. Some more of these despair deaths include drugs, alcohol, suicide, heart disease, and cancer.
Caruthersville is a town with a teen birth rate that as more than double the state average. Rarely do teen moms finish high school and go on public assistance.
Sadly, without an education, people have little hope. Drugs is the source of coping with life – yet another symptom of a public health crisis.
Not About Being Poor
It would be easy to say the problem is just about being poor, but research tells a different story. It is not that simple and a job, paycheck, and health insurance do matter.
But long-term and chronic illnesses like cancer, diabetes and heart disease damage quality of life. For example, people less educated are twice as likely to die from lung cancer.
Heart attacks and strokes: Middle aged adults with little high school education had heart attack at double the rate compared to people with a college degree.
But educated people tend to listen more to science, and often avoid engaging in dangerous behaviors. If you have a college education, you are more likely to wear restraints and change your smoke alarm batteries every year.
Disparities in education, health, and quality of life are other symptoms of a public health crisis.
Humanity’s greatest advances are not in its discoveries but in how those discoveries are applied to reduce inequity.